This trial was designed to test the hypothesis that LLLT reduces the extent and duration of postoperative pain, Twenty consecutive patients for elective cholecystectomy were randomly allocated for either LLLT or as controls. The trial was double blind. Patients for LLLT received 6-8-min treatment (GaAlAs: 830 nm: 60 mWCW: CM) to the wound area immediately following skin closure prior to emergence from GA. All patients were prescribed on demand postoperative analgesia (IM or oral according to pain severity). Recordings of pain scores (0-10) and analgesic requirements were noted by an independent assessor. There was a significant difference in the number of doses of narcotic analgesic (IM) required between the two groups. Controls n = 5,5: LLLT n = 2.5, No patient in the LLLT group required IM analgesia after 24 h. Similarly the requirement for oral analgesia was reduced in the LLLT group, Controls n = 9: LLLT n = 4. Control patients assessed their overall pain as moderate to severe compared with mild to moderate in the LLLT group. The results justify further evaluation on a larger trial population.
A total of 90 patients with radicular cervical spondylosis were treated by laser therapy combined with Traditional Chinese Medicine. The results showed that a total effective rate was 94.4% (11 cases demonstrated full recovery, 28 were graded markedly effective, and 46 improved). The author believes that this therapy for cervical spondylosis seems to be more effective and to have no side-effects compared with traction and drug therapy.
Keloids and hypertrophic scars are often encountered in the course of clinical practice in dermatology or plastic and reconstructive surgery clinics. There is however no precise definition of the hypertrophic scar or the keloid, thus there is no fixed established treatment methodology. The two growth-promotion factors in these lesions are physical, such as excessive motion in the tissue or stagnation of the vascular flow and pressure from the actual tissue growth itself, and chemical, from inflammatory response mediators and hormonal influence. As LLLT has been shown clinically and in scientific studies to have a regulatory effect on all of the above factors, a good therapeutic effect was anticipated from low reactive-level laser therapy applied to keloids and hypertrophic scars. Both the defocused Nd:YAG (1064 nm, 4 W, c/w, noncontact method) and the GaAlAs diode laser (830 nm, 60 mW c/w, contact and noncontact) have been used, with or without other laser or conventional surgery and conservative treatment modalities, with consistently good results, The psychological factors affecting patients are also taken into account. The ability to combine treatment of the physical aspects of such lesions using any or all of the available modalities, with an understanding and treatment of the psychological aspects, on an individualized basis, is essential to achieving consistently good results. This approach is referred to by Ohshiro as the Total Treatment Concept, Although recognizing the need for more detailed histochemical and histological studies, the authors suggest that LLLT offers a noninvasive and well-tolerated single or adjunctive therapeutic method for hypertrophic scars and true keloids.
Use of Low Reactive Level Laser Therapy (LLLT) utilizing helium-neon lasers has increased lately especially in pain control. New protocols are being developed aimed at a complex of primary and secondary symptomologies. One of these protocols Stellate Ganglion Stimulation has shown in our research a unique set of developments. Targeting the area of the stellate ganglion is showing great promise in the rehabilitation of patients with a history of chronic musculoskeletal pain syndromes, but several patients with preexisting psychological symptomology have exacerbated during the initial stages of utilizaton of this protocol. Patients with a history of psychological diagnosis for dysthymia, anxiety, post traumatic stress disorder or minor diffuse brain injury have shown an exacerbation of these symptomologies during the initial phases of stimulation treatment. Overall, response to this form of therapy seems to be positive but some patients require dermatomal and/or site-specific therapy to maximize outcome. With specific psychological treatment combined with a more conservative amount of stimulation initially the increase in these symptoms shows a tendency to remit with the pain response. Our continued research is currently focusing on the mechanisms for this type of response as well as protocol refinement to maximize its effectiveness.
Two hundred cases of acute and chronic articular, muscular and spinal pathologies have been treated with a defocused CO2 laser and with conventional treatment, representing in total 1515 treatments. The patients were then followed for 20 months. In evaluating the results the following parameters were considered: Average number of treatments; speed of improvement; assessed as totally cured, improved, little or no change and poor.